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SPELT s: _
s- APPLICATION FOR BUILDING PERMIT
Plumbin
HVAC Date:
Sprinkler 19 RIDGE ROAD
Electric Estimated Cost $ ON
Zoning Permit Fee$
Affidavit NO. 20054 Occupancy Fee $
Eng. Dept.
Fire Dept.COMPLETE RED BOXED AREAS.Total pee $
Health Dept. TYPE OR PRINT ONLY
Approved for CO: SIGN ON REVERSE SIDE. Additional Cost) $
TO BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR, CT
The undersigned, hereby applies to do work according to the following specifications:
Job Location Lot No. Side of Street Zone
Applicant t Tel. # A2 q&aj/!2
4,0 if
Address HAA giftt+ IV6.B, CT Zip OG 09r.1 Lic.# 4s"a to q4
STR ET CITY STA
Owner nn ftlj L l Address I A +' ?Qra s
aj
Architect Address
Size New Area: Ft. Front Overall Ft. Deep Overall Total Area Garages
Lavatories
Size of Lot Dist. from Street Line Bathrooms Rooms 1 st 2nd 3rd
Purpose of this Permit ss Li IV%a — V:yw t
City Water Well Septic Sewer
Use Group L Construction Type
Approved by 4W Date 6 `a e1.r-.2 BD1 A 11/88
I her by agree to conform to all th requirements of the Laws of th State of Connecticut and the Ordinances of the Town of South Windsor
and to notify the Building Inspector of any alteration in the plans or specifications of the Building for which this permit is asked,and agree
that this building is to be located the proper distance from all street lines,side yard lines and required distances from all other zones and is
located in a zone in which this building and its use is allowed.
J
Signed
I hereby apply for a Certificate of Occupancy for the work described in this application for permit.
Signed
DO NOT WRITE BELOW THIS LINE—
INSPECTION RECORD
Footing Framing
Foundation Fireplace/Chimney Insulation
Plumbing Permit# Inspections:
HVAC Permit# Inspections:
Electrical Permit# Inspections:
Sprinkler Permit# Inspections: